Early in July, Dr. Kathy Agoglia, a dentist who lives in Laurel, had meat for dinner. There was nothing unusual about her choice for a meal. But what happened afterward was quite unusual.
“An hour or so later I broke out in an itchy rash,” she said. “I was suspicious, as I know a little bit about ticks. And a month or so earlier I had been bitten by a Lone Star tick.”
She went to her primary care doctor in Mattituck and asked for a blood test for Alpha-gal syndrome, an allergic condition characterized by sensitivity to some meats. Unlike the deer tick, which can spread Lyme disease, Alpha-gal is caused by a bite from the Lone Star tick.
“I got a blood test, and it was positive,” she said.
Dr. Agoglia is one of nearly a half-million Americans living with Alpha-gal syndrome and the troublesome meat allergy that comes with it, according to studies by the Centers for Disease Control and Prevention published last week.
The CDC’s research says the highest number of AGS — for Alpha-gal syndrome — cases are in New York and Virginia, with perhaps 4% of all cases nationwide in Suffolk County. And that number is probably low, as the CDC report says many people with the syndrome go undiagnosed.
For Dr. Agoglia, and for experts in the Suffolk County Department of Health, the bullseye in the CDC report is the East End. While the CDC report is alarming in terms of AGS numbers, it adds another level of concern: the majority of health care providers it surveyed had little or no knowledge of the condition and were not sure how to diagnose it.
“We have to sound the alarm out here,” said Dr. Agoglia. “It’s here, it’s serious, and the numbers are very, very concerning.”
Why the East End of Suffolk is a hot spot for AGS is simple: the five towns are infested with very large numbers of deer, which carry the ticks.
“Anywhere where deer are in abundance, you will encounter the Lone Star tick,” said Dr. Erin McGintee, a regional expert on this tick who sees AGS patients in her Southampton office on a regular basis. She is also an appointed member of the Suffolk County Board of Health.
Estimates vary on the numbers of white-tailed deer in Riverhead and Southold. Some with knowledge of the population say total for both towns exceeds 7,000 — with hundreds more born each spring. Experts say a healthy population is about eight deer per square mile.
At that level, the total number of deer in Southold that wouldn’t destroy the understory in woods and drop ticks on backyards would be perhaps 600. In Riverhead, which has a larger land mass , a safe number would not exceed 2,000. The current number, in other words, has overwhelmed the natural environment and contributed to rise in tick-borne diseases such as AGS.
“This syndrome is getting a lot more attention now,” Dr. McGintee said, referring to the release of the CDC report, which was carried by major news media nationwide. “It’s a big, big problem out here.
“I’ve had over 900 patients in the last 12 years,” she added. “On the North and South forks it is epidemic. Most of my patients are from the South Fork because my practice is in Southampton, but I see many from the North Fork and some [from] as far west as Stony Brook and Wading River.
“The deer are a big problem,” she said. “There is not enough space, enough habitat for them. They don’t have any predators and they are a breeding ground for ticks.”
Dr. McGintee’s typical patient comes in with a severe reaction to eating meat, particularly hamburger or steak. The patient may not know if they had a recent tick bite. But they eat certain fatty meats and three to eight hours later they develop an allergic reaction.
Some experience hives and gastrointestinal issues; for others the reaction is more severe, with dizziness and difficulty breathing. Anaphylactic shock can occur. Symptoms may subside over time — but only if the patient doesn’t get another Lone Star tick bite. Additional bites make everything worse.
“I grew up in East Hampton,” Dr. McGintee said. “We had ticks when I was a kid, but we didn’t have this tick. People got Lyme disease; no one got this. Then the Lone Star tick became of the three major ticks here, but now you find more Lone Star ticks. It has outcompeted the other ticks and is now the dominant one.”
The Lone Star tick is believed to have originated in the Southeast. How it got here is anyone’s guess. Dr. McGintee, and others, speculate that the arrival of wild turkeys on the East End years ago introduced this tick to this habitat.
“On a typical day in my practice, I see at least three or four patients with a positive test,” she said. She urges people to get tested but, if you believe you were bitten by a Lone Star tick, to stay away from hamburger and other fatty meats. Stick with smaller portions and leaner meats, she advised.
While speculating on the spread of the tick with the growth of the turkey population, she said deer remain the major villain.
“If you don’t have a deer problem, you don’t have a tick problem,” she said. “The deer are the problem.”
Speaking in her Southold office between patients, Dr. Agoglia said she can eat chicken, turkey and fish. She hopes her symptoms will subside — and is careful to avoid being bitten again. She sprays her front and back yards to kill any ticks as a precaution.
“I also walk around with an EpiPen in my purse,” she said. “Severe reactions can still happen.”